Accident Date for Paper Claims

The following instructions are to enter information for accidents for submitting paper claims.

Instructions

1. Open an encounter.
2. In the History workflow step, select the Related Conditions screen. Note: Workflow Steps and Screens can be customized by each practice, thus, your Workflow Step and Screen name may be different. See Example
3. Click the checkbox for the appropriate "Related to" situation. 
   • If related to auto accident, select the appropriate state from the dropdown menu.
4. In the Accident Date field, input the information. Note: The accident date entered does not automatically populate on the CMS form when it is previewed or printed.
5. Click 'Next.'
   • HCFA, box 10, "Is Patient's Condition Related To," is populated from the encounter.
6. Open the invoice associated to the accident.
7. Ensure the invoice is in Pending.
8. Access the Additional Claim Info tab.
9. In field (15) Other Date, input the accident date. In the Qualifier field, select 439-Accident. See Example
10. Click 'Save.'